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Impaired memory is more closely associated with brain beta-amyloid than leukoaraiosis in hypertensive patients with

Eric E Smith1,2, Alona Muzikansky3, Cheryl R McCreary4

  • 1Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.

Plos One
|January 31, 2018
PubMed

Insights

Hypertension is linked to cognitive decline. Alzheimer's pathology, detected by PiB-PET, significantly impacts episodic memory in hypertensive individuals, even without dementia.

Area of Science:

  • Neuroscience
  • Gerontology
  • Cardiology

Background:

  • Hypertension is a major modifiable risk factor for subcortical ischemic changes and Alzheimer's dementia.
  • Investigating the pathological basis of early cognitive symptoms in hypertensive patients is crucial.

Purpose of the Study:

  • To use neuroimaging to explore the pathological underpinnings of early cognitive symptoms in hypertensive individuals.
  • To correlate neuroimaging findings with cognitive test performance in this population.

Main Methods:

  • A cross-sectional cohort study included 67 hypertensive patients (age >60) without dementia but with mild cognitive impairment or subjective cognitive concerns.
  • Magnetic Resonance Imaging (MRI) assessed subcortical vascular changes.
  • Positron Emission Tomography (PET) with Pittsburgh Compound B (PiB-PET) measured beta-amyloid deposition.

Main Results:

  • Episodic memory was significantly impaired (mean Z score -0.63).
  • Increased cortical PiB-PET binding was associated with lower episodic memory scores (0.14 SD lower per 0.1 unit increase).
  • Vascular markers (white matter hyperintensities, silent infarcts, microbleeds) did not correlate with cognitive scores.

Conclusions:

  • Episodic memory deficits in hypertensive individuals with cognitive concerns are linked to Alzheimer's pathology (beta-amyloid deposition).
  • This suggests a significant role of Alzheimer's pathology in cognitive impairment, even in those at high risk for vascular cognitive impairment.
Abstract

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